Individual
DR. CHRISTOPHER G BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
703 3RD ST RM 1120, WEST LAFAYETTE, IN 47907-2081
(765) 494-6995
Mailing address
617 DRIFTWOOD DR E APT 101, LAFAYETTE, IN 47905-6069
(314) 497-4844
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
20043106A
IN
Other
Enumeration date
01/22/2018
Last updated
01/22/2018
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